Mired in the Health Care Morass - Part 2

Posted by health4all

Posted: August 12, 2008 - 11:39 am

Continued from health4all posting July 28, 2008...

The illustrating image at the top of Chapter 5, "paying for hospitals," looks as if he were assembled from parts of an elephant, a dragon, and a human being. Nevertheless, he is not in any way a frightening creature, but rather he looks sad and doleful, perhaps resigned to the task of learning how hospital charges are determined so that he can negotiate lower charges. Again, like the previous chapter, most of this chapter needs to be studied and perhaps read more than once in order to fully understand all the factors involved in a hospital billing and price setting. In the end, however, Davis and his readers understand the extent to which hospitals have the ability to steeply discount their charges if pressed to do so.

Davis's writing style is straightforward and factual, but every now and then his basic values of decency and caring are revealed between the matter-of-fact sentences. For example:

... it was obvious that the hospital's discounts to Patricia had resulted in payments well below what Medicare or Medicaid would have paid were she a beneficiary. I also thought Patricia's oncologist had been underpaid, and wanting to make it right for both, I consulted with the oncologist and hospital authorities about the best way to rectify the situation. Their recommendations were to contribute to a local organization that helps low income cancer patients, and a local hospice, and that is what we did.

Chapter 6 is entitled "America's Health Care System." The illustration appears to be a juvenile monster with big feet, big claws, and a very hungry look. In any case, the chapter itself is a general, easy-to-follow but comprehensive discussion of the characteristics of the American health care system. This includes discussions of features such as national health care spending, a general description of the health-insurance industry, a discussion of health care spending in Alaska, examples of how a multiple payer health care system works, and even a brief section on the international health tourism industry.

Chapter 7 is entitled, "Comparison of Our System with That of Canada and Other Countries." Perhaps As a prelude to the ensuing discussion, the illustration is a set of earrings which feature tiny whimsical dancing figures as opposed to the gargoyles of previous chapters. This chapter offers concise descriptions of the structure and cost of health care systems in several European countries and in Canada in a generally favorable light. The chapter is well documented as are all the chapters.

Chapter 8, "How to Fix the American Health Care System," is adorned with the image of another of Patricia's ceramic gargoyle figures, but in this case it is an upbeat image of a smiling mother gargoyle holding her beaming baby gargoyle. In this chapter Davis characterizes liberal and right perspectives about health-care reform, lists a description of positive characteristics he thinks should be in health care reform, and finally concludes that "What is needed is single-payer universal health care..." The book includes an excellent glossary and, unlike many books in recent years, a detailed and useful index.

"Epilogue: the Rest of Patricia's Story" is the space in the book where Neil Davis, "geophysicist," and Neil Davis, "emerging health-care analyst," allows himself to be Neil Davis, "father." In this brief chapter Davis discusses a few anecdotes in the day-to-day encounters with the medical care system during his daughter's struggle for life. He ends the narrative with these words:

On the morning of July 31, 2006, I was holding Patricia in my arms as Rosemary and I were giving her a morphine injection [for pain]. I felt her whole body suddenly relaxed, and I knew then that our daughter was dead. We cannot know for sure, but things might have gone differently if, back in 2004, Patricia had been in a situation where she felt financially able to visit a doctor prior to being in stage three of her lung cancer at the time of diagnosis.

I found this book to be interesting, challenging in some of the more technical areas, extremely informative in those same areas, and especially interesting because of the Alaska focus. I recommend this book to anyone faced with large medical bills. I recommend this book to anyone who has a serious interest in the structure of health care financing in Alaska or nationally. I recommend this book to all health care and public health professionals, and I think this would be an excellent book for classroom use at the University. I commend the author for his ability and desire to turn personal tragedy into a public resource that will educate and help others.

Recently Davis confided in me that book sales are doing well. He has received mostly positive reviews both here and in Canada. He noted, perhaps with a hint of justifiable pride, that one physician purchased dozens of copies to give away, and a major health insurer purchased a hundred copies to distribute to employees.

Finally, I recommend that you take a look at Neil Davis's blog, http://healthcaremorass.blogspot.com/. He has some good postings on health care issues, lots of resources, and ordering details for the book.

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